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Impact of all oral anti-hepatitis C virus therapy:A metaanalysis

World Journal of Hepatology 2015年第5期7卷 806-813页

作者： siddharth bansal Ashwani K Singal Brendan M Mc Guire Bhupinder S Anand Department of Internal Medicine University of Alabama Birmingham Department of Gastroenterology and Hepatology University of Alabama Birmingham Department of Gastroenterology and Hepatology Michael E.DeB akey VA Medical Center and Baylor College of Medicine

AIM:To investigate the efficacy,safety,and cost of treatment of direct acting antivirals(DAAs) with and without peg interferon alfa2a(P),and/or ribavirin(R) in treating hepatitis C virus(HCV) genotype 1 ***:MEDLINE was searched for randomized controlled trials(RCT) using DAAs for HCV *** 1 trials and studies with investigational drugs on genotype 2 or 3,and on human immunodeficiency virus patients were *** were pooled for sustained virologic response(SVR),serious adverse effects,and drug discontinuation rate on various treatment arms in trials:P + R;1st generation DAA(telaprevir or boceprevir) + P + R;2nd generation DAA(sofosbuvir or simeprevir) + P + R;2nd generation DAA + R;two 2nd generation DAA + R;and two 2nd gen *** were analyzed separately for each arm for treatment naive and non-responders(NR) to previous *** cost of treatment with each regimen for achieving one SVR was also ***:Twenty three RCTs(n = 9354,62% male,11% cirrhosis) were *** oral(P free) regimens with combination of 2 DAA achieved SVR above 95%.The cost of treatment to achieve an SVR with DAA based regimens was lower for NR compared to P+R ***,the cost per SVR remained higher for treatment naive ***:Second generation and emerging DAAs are promising agents in HCV treatment,with a very high level of safety and *** important drawback is their high ***,the present meta-analysis shows that the cost per SVR for non responders(but not for naive patients) was lower compared to P + *** finding together with the superior safety profile and better compliance makes these drugs highly *** is possible that further reduction in treatment duration may make them even more cost effective.

关键词： Hepatitis C Meta-analysis Direct actingantivirals Oral agents Newer agents Hepatitis C virus

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Correlation between HbA1c and Extent of Mucormycosis Disease—A Prospective Observative Study

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第6期13卷 461-467页

作者： siddharth Nirwan Dhirendra Tak Pawan Singhal Anjali bansal Jitendra Kumar Jangir Anshu Dev Akshita Agarwal Kailash Singh Jat Anjani Kumar Sharma Department of Otorhinolaryngology Head and Neck Surgery SMS Medical College and Hospital Jaipur India

Background: Prognosis in Mucormycosis is poor, secondary to the nature of such opportunistic angioinvasive fungal infection that affects immuno-compromised patients with uncontrolled diabetes which is a common risk factors in most of the cases. Objectives: Patients with post-Covid Mucormycosis presenting to the ENT OPD were included and evaluated for HbA1c, extent of disease, and subsequently underwent the required modality of management. Methods: A prospective observational study was done in 154 patients of mucormycosis and according to the extent of disease such as sinonasal involvement, orbital extension or intracranial extension, the HbA1c values were compared among themselves. Results: In our study, out of 154 patients, 86 (55.8%) patients have only sinonasal involvement, 30 (19.4%) patients have extension into orbit and 38 (24.6%) patients have intracranial spread. In patients with sinonasal involvement, mean HbA1c was 9.8 ± 2.41;in orbital extension, mean HbA1c was 12.7 ± 2.31 and in intracranial extension, mean HbA1c was 13.4 ± 1.98. Conclusion: In our study, elevated HbA1c is indicative of poor glycaemic control and positively correlated with increased invasiveness and aggressive fungal disease.

关键词： Mucormycosis Immune-Compromised Patients HbA1c Values

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Diagnostic Role of Computerised Tomography in Mandibular Invasion among Patients with Oral Squamous Cell Carcinoma

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第6期13卷 429-441页

作者： Lokendra Singh Pawan Singhal Anjali bansal Dhirendra Tak Ravi Saharan Anshu Rawat Amreen Singh Mehak Anand Neeraj Kumar Bairwa siddharth Nirwan Kailash Singh Anjani Kumar Sharma Rajeev Yadav Department of Otorhinolaryngology Sawai Man Singh Medical College Jaipur India Department of Community Medicine Sawai Man Singh Medical College Jaipur India

Background: Oral cavity malignancy can result from surface epithelium, salivary glands, or submucosal soft tissue. Common symptoms may include non-healing ulcers, slurred speech, dysphagia, neck mass and pain which may indicate cortical invasion. Morbidity and quality of life have been seen to rise with mandibular excision in oral cavity squamous cell carcinoma. Therefore, in order to design the surgery appropriately, it is vital to be aware of the mandibular invasion prior to the procedure. Various researches have been focused on the accuracy of clinical examination and imaging technique in predicting tumour invasion of the mandible in oral malignancy. The goal of this study was to find a correlation between histological assessment, clinical examination, and computed tomography results in patients with mandibular involvement and oral cavity squamous cell carcinoma. Objectives: To determine the sensitivity, specificity, NPV and PPV of CECT and clinical diagnosis in patients with oral squamous cell carcinoma with mandibular invasion. Methods: A cross-sectional observational study was set out to review preoperative clinical and radiological assessment;and post operative histopathological finding of mandibular resection specimen in clinically evaluated and diagnosed cases of oral cavity squamous cell carcinoma (SCC) with mandibular invasion. Results: 43 individuals of oral cavity SCC with mandibular involvement were examined. 12 out of 28 mandibular resections had bone invasion, with numerous tumour entry sites being the most frequent mechanism of invasion, according to post-operative HPE. The positive predictive value (PPV) of contrast enhanced computerised tomography (CECT) scans was 42.8%, as 28 individuals had invasions revealed;sensitivity is almost 100%;specificity is 48.3. Conclusion: Prioritizing the identification of mandibular invasion is essential to enhance the prognosis of patients with oral SCC. There is an urgent necessity to review the usefulness of rad

关键词： Oral Squamous Cell Carcinoma Mandibular Invasion Mandibular Resection

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